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Dunham has been vocal about her obsessive-compulsive disorder.

First Dunham presents a photo of pills on her tongue with the caption “Can I live?” In the next, she shows a photo of Patty Duke reaching for pills and sobbing in the camp classic film Valley of the Dolls. “Lately I’ve been noticing that nearly every pop cultural image we see of a woman on psychiatric medication is that of an out-of-control, exhausting and exhausted girl who needs help,” she writes. “But guess what? Most women on meds are women who have been brave enough to help themselves.”

She has a point. It’s striking how portrayals of women with psychological problems have long depicted them as wild and unstable, not just since the ’60s (when Valley of the Dolls was released) but stretching back even earlier, when women were considered “hysterical” and sent to sanitariums to endure the “rest cure.”

Dunham has been vocal about her obsessive-compulsive disorder, and her character on Girls, Hannah Horvath, also struggles with OCD. But Dunham’s exploration of a young woman with mental illness has a long history. Charlotte Perkins Gilman’s classic feminist novella The Yellow Wallpaper broke boundaries by delving into the madness of a woman on a “rest cure” way back in the 1890s. When will this stereotype finally go away? Who knows—but it helps when more women like Dunham speak out about their own experience.